Can women nurses reduce ICU staff burnout?

A higher proportion of female nurses among intensive care teams may decrease individuals' risk of professional burnout, according to Swiss researchers who studied the factors related to burnout in the high-stress setting of the ICU.

The research appeared on the website of the American Journal of Respiratory and Critical Care Medicine, a publication of the American Thoracic Society.

Burnout is believed to be a psychological response to chronic stress, according to background information in the article. It can lead to emotional instability, feelings of failure and low production or an urge to leave the job.

"Avoiding and understanding burnout is especially important now, given the projected shortage of ICU caregivers, in addition to the intensity and costliness of training these specialized professionals," said Pablo Merlani, MD, attending physician at the University Hospital of Geneva.

To evaluate risk of burnout among different individuals in different settings, the researchers used a self-administered questionnaire that captured demographic data, personal characteristics, subjective stress and risk of burnout. They evaluated more than 3,000 individuals working in 72 Swiss ICUs. In addition to individual characteristics, they analyzed center-level factors (such as proportion of female caregivers among nurses and physicians) and patient-related factors.

In addition to the finding that a higher proportion of female nurses reduced overall risk of burnout, the researchers found other gender-related differences. While female caregivers were more likely to say that they experienced stress, they were more resistant to burnout than their male colleagues.

"This could be due to a methodological bias," Merlani said. "Indeed, female caregivers may have found it easier to admit their distress than did males. … Men may be less inclined to express their distress."

Among women caregivers, those who were young, single and without children were at the highest risk for burnout.

"Our study could open a new frontier concerning burnout in ICUs, highlighting the importance of the team composition," Merlani said. "Of course, our results should be confirmed in a prospective multicenter, multinational study. Whether the results can be exported to other medical settings where team-working is pivotal remains for the moment an interesting question to be investigated.

"In the meanwhile, ICU heads should ascertain that personnel at high risk would be especially taken care of, and that resources should be provided to afford psychological support and promote a team culture. This could finally also increase the number of women staying in ICUs, thereby reducing the overall risk of burnout."